Paediatric allergic reactions in the emergency department: a review

Abstract

Acute allergic reactions affect boys more than girls and frequently occur at a young age. Food allergies, in particular to nuts, are a major cause of reactions. Allergy represents a frequent presentation to the paediatric ED. There remains a concern about the adequacy of follow-up.

The diagnosis and management of children presenting with anaphylaxis to a metropolitan emergency department: A 2‐year retrospective case series

“…Discharge to home or ward is the most likely outcome identified in the literature, and in our cohort. Adequate follow‐up for children with anaphylaxis remains a concern, particularly for children with unspecified food allergy or an unidentified cause as a trigger …”

“…The incidence of anaphylaxis is increasing throughout the developed world. Srivastava et al suggested that a seven fold increase may have occurred in the last decade.…”

“…Anaphylaxis is a life‐threatening illness with an estimated lifetime prevalence of 0.05–2% . Studies have demonstrated that the incidence of allergic disease is rising in our community as part of a general increase in the developed world . There are limited data exploring emergency department (ED) management in Australia.…”

Hospitalizations due to allergic reactions in Finnish and Swedish children during 1999-2011

“…Several authors have reported on allergic reactions that resulted in presentation to the emergency department (ED) (12,14,15). Previous studies suggest that hospitalizations resulting from allergic reactions, including anaphylaxis and angioedema, occur in approximately 13-15% of children presenting with allergic reactions (10,(16)(17)(18).…”

Management of anaphylaxis in the emergency setting

“…Furthermore, failure to refer to allergy clinics is common. In one Scottish study, 40% of children with life-threatening reactions attending a pediatric emergency department received no follow-up, a finding echoed in other international studies [12,17,65,79]. Patients' lack of knowledge contributes to deaths from anaphylaxis [20] and the opportunity to improve patient care is being lost in the emergency department [3,22].…”